Financial Assistance

Franciscan Children’s is a nonprofit corporation that seeks to provide services to all pediatric patients in need of healthcare. Franciscan Children’s has a Financial Assistance Policy to assist patients and families who have a demonstrated financial need.

Financial assistance is available to uninsured US residents with household income less than 400% of the Federal Poverty Guidelines. If you qualify you will not be billed more than the amount generally billed to patients with insurance coverage.

In order to determined eligibility you must:

• Apply for any government medical assistance program for which you may be eligible.
• Complete, sign and date the Financial Assistance Application.
• Provide verification of all household income.
• Return your completed application to the Financial Counseling Department.

To download a Financial Assistance Application, please click here or use the button below.

Financial Assistance Application

Financial Assistance Policy Summary

To view our Patient Payments & Financial Assistance Plan in full, please click here.